Factors Affecting Participation in Breast Cancer Screening: A Cross-sectional Study

INTRODUCTION: Breast cancer is the most common malignancy in women; early detection through screening improves survival. This study aimed to compare patients diagnosed through screening with those diagnosed outside screening programs to identify factors influencing participation in breast cancer screening.
METHODS: A total of 356 breast cancer patients at Ankara Etlik City Hospital were surveyed and divided into screening-diagnosed and non-screening groups. Objective knowledge levels were assessed using a 10-item Breast Cancer Knowledge Test developed specifically for this study. Factors associated with screening participation were evaluated using univariate and multivariate logistic regression analyses.
RESULTS: Overall, 23% of patients were diagnosed through screening programs. Referrals for screening were most frequently made by family doctors (58%), followed by other doctors (19.8%) and social circles (12.4%). In the screening group, early stage (Stage I–II, p<0.001), higher educational level (p<0.001), regular self-breast examination (p<0.001), family history of breast cancer (p<0.001), and family history of other malignancies (p=0.025) were more frequent. Univariate analysis showed that higher educational level (p<0.001), family history of breast cancer (odds ratio [OR]=3.03; 95% confidence interval [CI]: 1.72–5.34; p<0.001), and family history of other malignancies (OR=1.77; 95% CI: 1.07–2.91; p=0.026) were associated with screening participation. In multivariate analysis, higher educational level (OR=5.60; 95% CI: 1.72–18.2; p=0.004) and family history of breast cancer (OR=2.48; 95% CI: 1.13–5.44; p=0.023) remained independent predictors.
DISCUSSION AND CONCLUSION: These findings show that breast cancer screening programs enhance early-stage diagnosis, with higher participation among women with higher education and a family history of breast cancer. Targeted education and active referrals for lower-educated and high-risk women are essential to increase participation.

Keywords: Breast cancer, early diagnosis, mammography, screening programs, stage of breast cancer